张帆 张燕萍 王均祎 陈军

1.福建醫科大学附属南平第一医院儿科，福建南平 353000;2.福建医科大学附属南平第一医院科研科，福建南平 353000;3.福建医科大学附属南平第一医院重症医学科，福建南平 353000;4.福建医科大学附属南平第一医院普外一科，福建南平 353000

[摘要] 目的 讨论标准化病人（SP）结合案例教学在医学生问诊培训中的应用分析，为进一步提升医学生临床技能教学质量提供参考。 方法 选择2018年9月至2019年9月在我院学习的五年制福建医科大学60名四年级医学生作为研究对象，采用随机数字表法，将学生分为SP教学组（试验组）和传统教学方法组（对照组），对试验组行SP教学效果满意度调查，比较两组问诊技巧及问诊综合能力教学效果。 结果 试验组各项调查结果满意率基本在90.00%以上（除SP表现满意度外）。期末试验组问诊技能考核（78.40±8.38）分，高于对照组（71.95±6.98）分，两组比较，差异有统计学意义（P<0.05），试验组问诊综合能力（84.69±10.94）分，高于对照组（75.56±9.68）分，两组比较，差异有统计学意义（P<0.05）。 结论 SP教学法在医学生问诊培训中教学效果显著且学生满意率高，应进一步通过加强组织建设、建立有效机制提升SP在医学生教育中的应用效果。

[关键词] 标准化病人;医学生;教学;培训

[中图分类号] R4          [文献标识码] B          [文章编号] 1673-9701（2021）08-0141-04

Application analysis of standardized patient combined with case teaching in medical students′ consultation training

ZHANG Fan1   ZHANG Yanping2   WANG Junyi3   CHEN Jun4

1.Department of Paediatrics， the Nanping First Affiliated Hospital of Fujian Medical University， Nanping   353000， China; 2.Department of Scientific Research， the Nanping First Affiliated Hospital of Fujian Medical University， Nanping 353000， China; 3.Department of Critical Care Medicine， the Nanping First Affiliated Hospital of Fujian Medical University， Nanping   353000， China; 4.First Department of General Surgery， the Nanping First Affiliated Hospital of Fujian Medical University， Nanping   353000， China

[Abstract] Objective To discuss the application analysis of standardized patient（SP） combined with case teaching in medical students′ consultation training， and to provide references for further improving the quality of clinical skills teaching for medical students. Methods Sixty fourth-year medical students of five-year Fujian Medical University who studied in our hospital from September 2018 to September 2019 were selected as the research objects. Using random number table method， the students were divided into the SP teaching group（test group） and the traditional teaching method group（control group）. The SP teaching effect satisfaction survey of the observation group was conducted. The teaching effect of the two groups′ consultation skills and comprehensive ability was compared. Results The satisfaction rate of the SP investigation effect was basically above 90.00%（except the satisfaction rate of SP performance）， the scores of questioning skills（78.40±8.38） at the final test group were higher than those of the control group（71.95±6.98）. The difference between the two groups was statistically significant（P<0.05）. The comprehensive ability to consulting in the test group was（84.69±10.94） points， higher than（75.56±9.68） points of the control group， and the difference between the two groups was statistically significant（P<0.05）. Conclusion The teaching effect of SP teaching method in medical students' consultation training is remarkable， and the student satisfaction rate is high. It is necessary to further strengthen the organization and establish effective mechanisms to improve the application effect of SP in medical student education.

[Key words] Standardized patients; Medical students; Teaching; Training

标准化病人（Standardized patient，SP），又叫做病人指导者，选取正常人或病人，经过专业系统培训，通过模拟临床情境及患者就医过程，在临床教学过程中起協助及指导作用。标准化病人同时担任患者、教师及评估者三种角色，为临床教学及同质化提供极大帮助[1]。在医学教育中，SP技术在医学生及住院医师临床技能训练和考核中起到重要作用[2-3]。医学必须通过不断临床实践来提升临床诊治水平。近些年来，在经济发达地区，SP已广泛应用于临床教学中，包括诊断学病史采集、体格检查、临床技能培训、医患沟通等众多方面，在医学生临床技能考核中的应用也取得了公认的成效[4]。……